Midwife-led birthing centres in four countries: a case study

BMC Health Services Research

Research

Sabera Turkmani¹  Caroline S. E. Homer¹  Rose Chalo Nabirye²  Joshua Epuitai²  Abu Sayeed Abdullah³  Fazlur Rahman³  Abdul Halim³  Oliva Bazirete⁴  Sofia Castro Lopes⁵  Tasleem Ayaz⁶  Shree Mandke⁷  Mandy Forrester⁷  Sally Pairman⁷  Scovia Nalugo Mbalinda⁸  Faith Nawagi⁸  Kirsty Hughes⁹  Andrea Nove⁹  Razia Naveed^1,10  Zainab Khawaja^1,10  Saad Ibrahim Rasheed^1,10  Hania Rehman^1,10  Sheila E. Clow^1,11  Karin Minnie^1,12 

[1] Burnet Institute, Melbourne, Australia;Busitema University, Tororo, Uganda;Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh;College of Medicine and Health, Sciences, University of Rwanda, Kigali, Rwanda;Novametrics Ltd, Duffield, UK;Independent Consultant, Cape Town, South Africa;Independent Consultant, Islamabad, Pakistan;International Confederation of Midwives, The Hague, Netherlands;Makerere University, Kampala, Uganda;Novametrics Ltd, Duffield, UK;Research & Development Solutions, Islamabad, Pakistan;University of Cape Town, Rondebosch, South Africa;University of the Western Cape, Cape Town, South Africa;

关键词: Midwife led birthing centre;    Midwifery;    Childbirth;    Low and middle income countries;    Bangladesh;    Pakistan;    South Africa;    Uganda;   

DOI  :  10.1186/s12913-023-10125-2

 received in 2023-06-01, accepted in 2023-10-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMidwives are essential providers of primary health care and can play a major role in the provision of health care that can save lives and improve sexual, reproductive, maternal, newborn and adolescent health outcomes. One way for midwives to deliver care is through midwife-led birth centres (MLBCs). Most of the evidence on MLBCs is from high-income countries but the opportunity for impact of MLBCs in low- and middle-income countries (LMICs) could be significant as this is where most maternal and newborn deaths occur. The aim of this study is to explore MLBCs in four low-to-middle income countries, specifically to understand what is needed for a successful MLBC.MethodsA descriptive case study design was employed in 4 sites in each of four countries: Bangladesh, Pakistan, South Africa and Uganda. We used an Appreciative Inquiry approach, informed by a network of care framework. Key informant interviews were conducted with 77 MLBC clients and 33 health service leaders and senior policymakers. Fifteen focus group discussions were used to collect data from 100 midwives and other MLBC staff.ResultsKey enablers to a successful MLBC were: (i) having an effective financing model (ii) providing quality midwifery care that is recognised by the community (iii) having interdisciplinary and interfacility collaboration, coordination and functional referral systems, and (iv) ensuring supportive and enabling leadership and governance at all levels.ConclusionThe findings of this study have significant implications for improving maternal and neonatal health outcomes, strengthening healthcare systems, and promoting the role of midwives in LMICs. Understanding factors for success can contribute to inform policies and decision making as well as design tailored maternal and newborn health programmes that can more effectively support midwives and respond to population needs. At an international level, it can contribute to shape guidelines and strengthen the midwifery profession in different settings.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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